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Every year, on November 14, the world observes World Diabetes Day. It reminds us that diabetes affects nearly one in eight adults in Trinidad and Tobago, yet it remains one of the most manageable chronic diseases—once we know what to look for. This year’s theme, Diabetes and the Workplace, highlights how the condition affects people in their daily lives, not only in the clinic. Seven in ten people with diabetes are of working age, and many struggle to balance self-care with job demands. The impact is not just physical. Three in four people experience anxiety, depression, or another mental health condition, and four in five report “diabetes burnout”—the exhaustion that comes from the constant attention needed to manage the condition. Recognising these emotional and occupational challenges is just as important as managing blood sugar itself. Diabetes is also increasingly affecting children and teenagers. Rising rates of obesity, poor diet, and inactivity mean more young people are developing type 2 diabetes than ever before. Sometimes, diabetes in young women is first discovered during pregnancy—a condition known as gestational diabetes. This not only affects the mother’s health but can cause complications for the baby, such as high birth weight and difficult delivery. It also increases the mother’s risk of developing diabetes later in life. The good news is that early screening, healthy eating, regular physical activity, and weight management can help prevent or delay diabetes, even in those at high risk. Diabetes care today is about more than just lowering your sugar. It is about education, tracking your health, and making informed choices under the guidance of your healthcare team. Knowing your numbers—and keeping up with regular screening and vaccines—can prevent the serious complications that diabetes can bring. Know your key number targets If you live with diabetes, five key indicators tell you whether your care is on track: • HbA1c (glycated haemoglobin)—Shows your average sugar levels over the past three months. Keeping it under control helps prevent eye, kidney and nerve damage. For most adults, the target is below 7%, though your doctor may individualise this goal. • Blood pressure—Diabetes and high blood pressure often go hand-in-hand. Good control prevents stroke, heart disease, and kidney damage. The goal is usually below 130/80 mm Hg, or closer to 120/80 if there is kidney or heart disease. • Cholesterol—The “bad” LDL cholesterol should be kept as low as possible—under 100 mg/dL for most; or under 70 mg/dL if you already have heart disease. • Kidney function—A blood test (creatinine) shows how well your kidneys work, while a simple urine test (albumin-to-creatinine ratio) can detect early protein leakage—the first sign of diabetic kidney damage. The target is less than 30 mg/g. • Weight and waist size—Maintaining a healthy waistline is one of the strongest defences against diabetes and heart disease. For people of East Indian descent, the limit is below 90 centimetres (35 inches) for men, and 80 centimetres (31 inches) for women. For others, roughly below 40 inches for men and 35 inches for women. Even small improvements—lowering your sugar, pressure or cholesterol—can cut your risk of going blind, losing a kidney, or having a heart attack by more than half. Stay up to date with screenings Diabetes silently affects different organs, so routine screening is vital: • Eyes—A dilated eye exam at least once a year checks for diabetic retinopathy. • Feet—Yearly foot checks look for nerve damage (neuropathy) and poor circulation (peripheral artery disease). Early testing helps prevent ulcers and infections. • Lab tests—HbA1c every three to six months, cholesterol and kidney tests yearly, or more often if needed. • Mind—Mental health screening is now part of good diabetes care. Emotional well-being should be assessed at least once a year. Vaccines are part of diabetes care People with diabetes are more prone to infections. Staying current with vaccines helps you stay healthy. Every person with diabetes should have: An influenza vaccine every year; pneumococcal vaccines to prevent pneumonia; hepatitis B vaccine if not already immunised; shingles vaccine for those 50 years and older; and Tdap booster (tetanus, diphtheria, and pertussis) every ten years. If you are living with diabetes, talk with your healthcare provider to ensure your numbers and screenings are on track. If you don’t have diabetes, check your blood sugar every three years starting at age 35, or sooner if you are overweight, have a family history, or other risk factors. Dr Shastri Motilal senior lecturer in family medicine, The UWI; chair, Helen Bhagwansingh Diabetes Education, Research and Prevention Institute (DERPI)
